Fig. 14. A. A 28-year-old woman has bilateral lacrimal gland enlargement due to sarcoidosis. B. Axial CT image demonstrates bilateral lacrimal gland and orbital involvement in sarcoidosis. Note that orbital masses conform to bony orbital contour and are not associated with bony destruction. C. Coronal CT image of orbital sarcoidosis. D. T2-weighted MRI image of orbital sarcoid. Orbital masses appear black in this image. Orbital tissue is displaced medially. E. Noncaseating granuloma of orbital tissue. Sarcoid-type granuloma contains spindle-shaped and epithelioid cells, lymphocytes, and giant cells. Typical sarcoid granulomas are usually tightly formed, sharply delimited, and “naked” of a lymphocytic rim (H&E, ×375).